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TUR in Salineuniversal resectoscope
2 TUR in Saline atom• • • • • •
For 20 years now EMED has been involved in the manufacture of top-quality electrosurgical
systems. Our considerable experience and continually evolving technology have enabled
us to set new trends in electrosurgery.
Our aim is to deliver devices as simple to operate as possible. This would make it possible
to take a full advantage of the opportunities offered by advanced electrosurgical methods
in medical procedures.
Electrosurgery is a constantly developing discipline of medical technology. It has been
applied for dozens of years and is still looking for novel approaches as well as more
effective and safer solutions. With an enhanced range of electrosurgical applications
in a number of different specializations, electrosurgical systems have become more complex
and complicated, while the scope of available functionalities and operational modalities
has not necessarily matched the actual needs and requirements of their users.
Atom is the first electrosurgical system which combines perfectly well a small size and a wide
spectrum of applications.
Atom is a compact device which offers possibilities which have so far been provided by large
and complicated electrosurgical systems only. It features monopolar and bipolar techniques
in a variety of cutting and coagulation modes. The generator features highly-specialized
operating modes, e.g. bipolar resection, an endoscopic cutting procedure and ThermoStapler®
- a system for sealing large blood vessels. An integrated argon module brings the benefits from
argon plasma coagulation and cutting.
atomcreate your performance
atom TUR in Saline 3 • • • • • •
Connect the instrument and start working
Atom does not require any complicated pre-procedure
configuration – you simply need to connect the instrument.
The system will automatically detect it and adjust the appropriate
settings.
The device is equipped with SmartDevice (SDS) sockets.
The SDS system detects and identifies the connected
instrument. Atom automatically adjusts the operating mode
and output settings, thus ensuring greater comfort and safety
of work. If the settings are changed during the procedure,
the device will store them in memory, and automatically recall
them when the instrument is connected for the next procedure.
Atom is a system which easily adapts to the user. Since it is possible to configure
in any way the available operating modes, each user can set up an electrosurgical
system that accurately meets the actual needs and requirements.
Based on the configuration options for each operating mode, the electrosurgical
system can be freely adjusted to the specialist’s needs and requirements.
With an innovative user interface as well as a large and easy-to-read touchscreen,
the operation of the system is simple and intuitive.
atomcreate your performance
4 TUR in Saline atom• • • • • •
Atom is equipped with a power monitoring
system which shows the diagram of instanta-
neous output power and the average power
value after the cutting or coagulation process
is completed.
Atom is fitted out with an advanced measuring system which automatically adjusts
in real-time the output power to the changing conditions within the operating field based
on measurements of the output parameters.
The automatic adjustment of output power
is specially important for bipolar resection modes
of operation. The advanced automatic system
enables the immediate ignition of the electric arc
and helps to easily start cutting with minimum
thermal energy delivered to the patient’s tissues.
atomcreate your performance
atom TUR in Saline 5 • • • • • •
Bipolar technique
Bipolar resection modes require the use of an electrically conductive liquid,
e.g. a saline solution. URO BI-CUT allows for very efficient cutting and vaporization
in TUR procedures. URO BI-COAG ensures effective contact coagulation of local
bleedings using loop or ball electrodes. The high-frequency current flows through
the conductive liquid between the active electrode and the resectoscope sheath,
which becomes the passive element.
Monopolar technique
Monopolar resection modes require the use of a non-conductive liquid, e.g. glycine.
In those modes the high-frequency current flows between the active electrode
introduced through the resectoscope and the outer neutral electrode applied
on the skin of a patient. For many years the monopolar technique has been used
as the “Gold Standard” for TUR procedures.
The choice of the optimal surgical technique depends on a number of factors.
The decision is always taken by the operating surgeon.
Along with the EMED resectoscope, the atom system is a multipurpose set which
is always ready for use, whatever operating technique is chosen.
The atom system offers specialized cutting and coagulation modes designed for bipolar and monopolar resections.
The cutting and coagulation parameters in both options have been chosen so as to enable surgeons to achieve the best
possible results in a specific working environment. As soon as the SDS cable is connected, the atom system determines
the appropriate operating mode (monopolar or bipolar resection) and the corresponding settings.
atomcreate your TUR standard
6 TUR in Saline resectoscope• • • • • •
A complete solution designed for transurethral electroresection procedures
The EMED resectoscope is a multifunctional instrument, which enables bothmonopolar and bipolar operations without changing the working elements.It is fitted out with a rotary sheath with the continuous flow function.
Benefits of continuous flow function:
To ensure the comfort of use, the working element is available in two versions: active or passive, according to the operator’s preferences and habits.The resectoscope operates with reusable active electrodes for cutting, coagulation and tissue vaporization, which reduces the cost of the procedure.
resectoscopeone system – many features
• helps to quickly remove tissue fragments and replace the irrigation solution,
• reduces the temperature of the irrigation solution when it is heated up by the energy generated by the electrosurgical unit,
• ensures a clean operating field.
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Loop electrode wide PI-CUT Ball electrode 5mm, angled
resectoscope TUR in Saline 7 • • • • • •
Choose your own operating technique
A single device which enables the application of the monopolar or bipolar technique is a great convenience in everyday work. The resectoscope is designed for connecting the monopolar or bipolar cable without changing the components of the operating set.
Benefits of bipolar technique:Bipolar resection
in saline
Bipolar coagulationwith loop electrode
Bipolar coagulationwith ball electrode
resectoscopeone system – many features
• a limited current flow path through the patient’s body,
• it can be used for patients with cardiac pacemakers or cardiac problems,
• a limited high-frequency current flow path reduces the risk of irritation of the obturator nerve during resections of urinary bladder tumors,
• there is no need to use an external neutral electrode this helps to eliminate the risk of burns due to spills or incorrect application of the neutral electrode,
• the use of a saline solution for irrigation helps to extend the duration of the procedure this is especially important during resections of large-size lesions,
• he use of a saline solution helps to reduce the risk of the transurethral resection syndrome (the TUR syndrome).
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8 TUR in Saline resectoscope• • • • • •
resectoscopecomfort and safety
Connecting of the monopolar cable
The working element is available in active and passive versions
A quick and easy assembly of all the components
Connecting of the bipolar cable
resectoscope TUR in Saline 9 • • • • • •
The continuous flow feature for cleaning of the operating field and replacing the irrigation solution.
A rotary, perforated sheath
The ceramic insulation protects the telescope from electrical arcs.
10 TUR in Saline resectoscope• • • • • •
The monopolar electroresection method continues to be the Gold Standard for the treatment of benign prostate hyperplasia. The introduction of the bipolar technique into transurethral electroresection procedures has led to the search for new operating standards. The results of comparative studies undertaken over the last few years have shown that both techniques are just as effective. However, the greater safety afforded by the bipolar procedure is its most obvious advantage [3,5].
Monopolar or bipolar?
resectoscopemonopolar and bipolar electroresection
(1) Arch Ital Urol Androl. 2013 Jun 24;85(2):86-91, Comparative randomized study on the efficaciousness of endoscopic bipolar prostateresection versus monopolar resection technique. 3 year follow-up. Giulianelli R, Albanesi L, Attisani F, Gentile BC, Vincenti G, Pisanti F, Shestani T, Mavilla L, Granata D, Schettini M.
(2) Prog Urol. 2014 Feb;24(2):121-6. [Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study]. Ghozzi S, Ghorbel J, Ben Ali M, Dridi M, Maarouf J, Khiari R, Ben Rais N.
(3) Curr Opin Urol. 2009 Jan;19(1):26-32. Bipolar transurethral resection of the prostate: the ‘golden standard’ reclaims its leading position. Mamoulakis C, Trompetter M, de la Rosette J.
(4) Curr Opin Urol. 2008 Jan;18(1):50-5. Bipolar transurethral resection of prostate: a new reference standard? Ho HS, Cheng CW.
(5) Int Braz J Urol. 2010 Mar-Apr;36(2):183-9. Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection. Singhania P, Nandini D, Sarita F, Hemant P, Hemalata I.
• similar effectiveness resulting in less severe symptoms from the lower urinary tract [1],
• lower blood losses when the using bipolar technique [4],
• a shorter catheterization period with the bipolar technique [1,2,4],
• a shorter post-procedure hospitalization period and less severe symptoms of irritation after using the bipolar technique [3,4],
• reduced risk of the TUR syndrome when the using bipolar technique [3,4].
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atom TUR in Saline 11 • • • • • •
Ref. No.
100-620 Electrosurgical Unit atom
080-061TinyLine trolley, with case for accessories
100-313MultiSwitch, 2-button footswitch,wireless
100-303MultiSwitch, 2-button footswitch, 6-pin plug, 5m cable
transurethral electroresectionatom and accessories
12 TUR in Saline resectoscope• • • • • •
380-030
380-050
3 m
5 mCable for disposable neutral electrode. flat plug
812-80H 176x122 mmDisposable neutral electrode EMED SAFE, hydrogel, split, for adults and children, 110 cm2,, 10x5 pcs.
SDS plug Ref. No. cable lenght
354-04S 4.5 m Bipolar cable for resectoscope
405-04S 4.5 mMonopolar cable for resectoscope, 2 mm male plug
Ø 2 mm
176 mm
122
mm
transurethral electroresectionaccessories
resectoscope TUR in Saline 13 • • • • • •
Ref. No.
630-235-10BActive working element, monopolar/bipolar, for 4 mm telescopes
630-235-60BPassive working element, monopolar/bipolar, for 4 mm telescopes
630-210-26Continuous flow sheath 24/26Fr., perforated, turnable, 2 stopcocks
630-215-24Obturator standard for resectoscope 24/26Fr.
transurethral electroresectionuniversal resectoscope
380-030
380-050
3 m
5 mCable for disposable neutral electrode. flat plug
812-80H 176x122 mmDisposable neutral electrode EMED SAFE, hydrogel, split, for adults and children, 110 cm2,, 10x5 pcs.
14 TUR in Saline resectoscope• • • • • •
Ref. No.
630-240-00BPILoop electrode wide PI-CUT, angled; 24/26Fr., 30° telescopes
630-240-00BLoop electrode, angled; 24/26Fr., 30° telescopes
630-240-15BBall electrode 3 mm, angled; 24/26Fr., 30° telescopes
630-240-20BBall electrode 5mm, angled; 24/26Fr., 30° telescopes
601-104-39Telescope autoclavable, dia. 4 mm, L: 300 mm, 30°
transurethral electroresectionuniversal resectoscope
resectoscope TUR in Saline 15 • • • • • •
Ref. No. dimensions
260-600-04Y 460x80x55 mm Optic wire basket with fixation for 1 optic
260-191-07Y 540x250x70 mm Wire basket for 1/1 container
260-100-01Y 595x275 mm 1/1 lid; perforated; aluminium silver
260-105-15Y 595x275x150 mm 1/1 bottom; non perforated; aluminium
260-852-30Y 520x230 mm Silicone mat, green
transurethral electroresectioncontainers for sterilization
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March 2015